News · Research28 September 20264 min read

Game-based learning in medical education: an attending-run card game lifted resident engagement on rounds

Game-based learning in medical education now has randomized-trial data from hospital rounds, and on 25 September 2026 the AMA brought it to residents nationwide. In a 22-week study at Jefferson Health in Philadelphia, internal medicine residents who played Round34, a cooperative card game moderated by the attending physician during teaching rounds, rated rounds higher for educational value (8.0 vs 6.2 on a 10-point scale), engagement (8.5 vs 7.1) and comfort asking questions (9.1 vs 8.2), and the study found no difference in rounding time. The paper appeared in February 2026 in the Journal of Graduate Medical Education (2026;18(1):43–50).

What the Round34 study found

Game teams scored rounds higher on all three primary outcomes (each P<.0001), with no added rounding time.

Paired inpatient internal medicine teams at one academic center were randomized in 2024 to play Round34 during teaching rounds or to round as usual. After adjusting for patient volume, call days and round duration, gameplay stayed independently associated with the better scores (Baig et al., JGME 2026).

Data: 274 of 455 daily and 54 of 91 weekly responses (PubMed 41694777).

How the game fits into rounds

Round34 is an investigator-developed cooperative card game played during teaching rounds, with prompts that range from humor to clinical questions.

Pulmonologist Saqib Baig, MD, MS, and Vincent Chan, MD, built it for two problems the paper names: high team turnover and hierarchical dynamics that limit engagement and comfort asking questions. Dr. Baig told the AMA:

“This game can help lower the initial barrier that people might feel when they start on a team.”Saqib Baig, MD, MS, to the AMA

Why the facilitator matters in this design

The study's own title calls the method “attending-moderated tabletop gameplay”: the attending physician runs the game.

A card deck on its own is a set of prompts. Someone has to choose the moment, keep the pace, make it safe for the junior-most person to speak, and tie answers back to clinical learning. In our reading, those are the core tasks of a game facilitator, done here by a physician during clinical work. Facilitators who run short games with new corporate teams can share session designs of this kind in our Team Building hub.

What this means for L&D, medical educators and game authors

• L&D and GME leaders: treat a facilitated game as a measurable team-dynamics tool. Copy Round34's design (daily 10-point surveys, recorded rounding time) when you pilot a game, and brief whoever runs it on what a game facilitator actually does.
• Game authors and publishers: a published trial with daily measures sets a clear bar for evidence. Bring your game to the Educational Games or Team Building hub to compare session designs and outcomes.
• Facilitators: founding members help define the competencies behind the game facilitator certification framework now being drafted.

Limits worth knowing

This is one trial at one center, with self-reported outcomes.

Response rates were about 60% (274 of 455 daily and 54 of 91 weekly surveys). The study found no differences in burnout, well-being or loneliness, so the measured gains concern the learning climate of rounds.

Sources: Baig S, Dong MQ, Sirapu S, Chan V. J Grad Med Educ. 2026;18(1):43–50; AMA, 25 September 2026.